{"id":558,"date":"2020-07-14T00:11:12","date_gmt":"2020-07-14T00:11:12","guid":{"rendered":"http:\/\/stimrouter.pixelsmith.co\/?page_id=558"},"modified":"2024-12-17T08:20:03","modified_gmt":"2024-12-17T15:20:03","slug":"talk-to-a-patient-advocate","status":"publish","type":"page","link":"https:\/\/stimrouter.com\/en\/utilities\/talk-to-a-patient-advocate\/","title":{"rendered":"Talk to a Patient Advocate"},"content":{"rendered":"\n<div id=\"acf\/banner-block_203c4853dc827d52105868506fb5d70e\" class=\"pxblock pxblock--banner banner text-color--light height--short\">\n\t\n\t<div class=\"container\">\n\t\t\t<\/div>\n\n\t\t\t<img decoding=\"async\" class=\"banner__wave\" src=\"\/wp-content\/themes\/stimrouter\/assets\/images\/wave-image.svg\">\n\t<\/div>\n\n\n\n<div id=\"acf\/text-block_4c7fc16c06ab90758bdf964fa38f9f31\" class=\"pxblock pxblock--text text width--default\">\n\t\n\t<div class=\"container\">\n\t\t<h2>I\u2019d like to talk to a PNS Patient Advocate<\/h2>\n<p>The PNS Patient Advocate Program is a way for patients with chronic pain to connect with actual StimRouter patients to ask them about their chronic pain journey while they consider options for the treatment of their chronic pain.<\/p>\n<p>&nbsp;<\/p>\n<p>Please provide the following information so we can connect you with the advocate best able to answer your questions.<br \/>\n&nbsp;&nbsp;<br \/>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f7172-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"7172\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/558#wpcf7-f7172-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"7172\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f7172-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<table class=\"order-online custom-width\">\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">First Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Last Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Country<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"country\"><option value=\"USA\">USA<\/option><option value=\"Canada\">Canada<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"The Bahamas\">The Bahamas<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Belize\">Belize<\/option><option value=\"Bolivia\">Bolivia<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"Chile\">Chile<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Dominica Republic\">Dominica Republic<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Panama\">Panama<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Peru\">Peru<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Saint Vincent and The Grenadines\">Saint Vincent and The Grenadines<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"Venezuela\">Venezuela<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Zip Code<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zip-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip-code\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p>ZIP \/ Postal Code\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Email<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label class=\"required\">Phone Number<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>Preferred time of day for call<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"preferred-name\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"preferred-name\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Morning\">Morning<\/option><option value=\"Afternoon\">Afternoon<\/option><option value=\"No preference\">No preference<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>How long have you been experiencing pain?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"experiencing-pain\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"experiencing-pain\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Less than 6 months\">Less than 6 months<\/option><option value=\"6 months - 1 year\">6 months &#8211; 1 year<\/option><option value=\"1-2 years\">1-2 years<\/option><option value=\"More than 2 year\">More than 2 year<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><label>What type of questions do you have for a StimRouter patient?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"questions\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"questions[]\" value=\"About the procedure\" \/><span class=\"wpcf7-list-item-label\">About the procedure<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"questions[]\" value=\"About the results\" \/><span class=\"wpcf7-list-item-label\">About the results<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"questions[]\" value=\"About cost\" \/><span class=\"wpcf7-list-item-label\">About cost<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><label class=\"required\">Do you have any other questions?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-questions\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-questions\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t<span class=\"wpcf7-form-control-wrap recaptcha\" data-name=\"recaptcha\"><span data-sitekey=\"6LfL22QqAAAAAH1xmP4oPng3KX0DzAc51zSYH5ok\" class=\"wpcf7-form-control wpcf7-recaptcha g-recaptcha\"><\/span>\r\n<noscript>\r\n\t<div class=\"grecaptcha-noscript\">\r\n\t\t<iframe loading=\"lazy\" src=\"https:\/\/www.google.com\/recaptcha\/api\/fallback?k=6LfL22QqAAAAAH1xmP4oPng3KX0DzAc51zSYH5ok\" frameborder=\"0\" scrolling=\"no\" width=\"310\" height=\"430\">\r\n\t\t<\/iframe>\r\n\t\t<textarea name=\"g-recaptcha-response\" rows=\"3\" cols=\"40\" placeholder=\"reCaptcha Response Here\">\r\n\t\t<\/textarea>\r\n\t<\/div>\r\n<\/noscript>\r\n<\/span>\n\t\t\t<p>By clicking submit, I consent to receive email and phone communications at the above provided email address and phone number sent from or on behalf of Bioventus.\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"180\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/p>\n\t<\/div>\n<\/div>\n\n\n\n<style>\n\t@media (min-width: 768px) {\n\t\t.columns__row > .columns__column.columns__column--1 {\n\t\t\twidth: 100%;\n\t\t}\n\t}\n<\/style>\n\n<div id=\"acf\/columns-block_3ad317cb210f57b379ed4de9ac6a31da\" class=\"pxblock pxblock--columns columns\">\n\t\n\t<div class=\"container\">\n\t\t\n\t\t<div class=\"columns__row\">\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":29,"featured_media":0,"parent":2571,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":true,"footnotes":""},"class_list":["post-558","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/558","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/comments?post=558"}],"version-history":[{"count":0,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/558\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/pages\/2571"}],"wp:attachment":[{"href":"https:\/\/stimrouter.com\/en\/wp-json\/wp\/v2\/media?parent=558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}